Experience with Hysterolaparoscopy in a Fertility Center in Southeastern Nigeria: A 5-Year Retrospective Review

A bstract Background: Infertility is a global problem which can contribute to marital disharmony. Proper and requisite management of female infertility demands proper and prompt diagnosis of its cause. Diagnostic laparoscopy and hysteroscopy have become indispensable procedures in the female infertility work-up. Objective: We aimed to evaluate the use of laparoscopy and dye test with hysteroscopy in the management of infertile women in a private fertility center in southeast, Nigeria. Materials and Methods: This is a retrospective review of 214 infertile women who underwent hysterolaparoscopies over a five year period (January 2016 to December 2020) in a private fertility center in southeast Nigeria. The biodata, duration of infertility, indications, and pathological findings were obtained. Analysis was carried out using IBM SPSS statistics version 20. Frequency tables, simple percentages, and component bar charts were used for data representation. Results: The prevalence of secondary and primary infertility was 4.4% and 3.9%, respectively, with a mean infertility duration of 5.8 (95% CI 5.2–6.3) years. The commonest abnormal laparoscopic finding was pelvic adhesion (123, 57.3%), followed by tubal occlusion (93, 43.5%); More than one-fourth of tubal occlusion cases were bilateral and occurred more at the proximal portion of the tubes. The prevalence of endometriosis and endometrioma were 5.6% ( n = 11) and 1.4% ( n = 3), respectively. The commonest uterine pathology was uterine synechiae (47, 22.0%), followed by submucus uterine leiomyomata (27, 12.6%). Endometrial polyp was diagnosed in less than one-tenth (16, 7.5%) of the women. The commonest interventions performed were adhesiolysis (30, 14.3%) and polypectomy (11, 5.1%). There was no complication observed. Conclusion: Many abnormal findings on hysterolaparoscopy were observed among infertile women in Southeastern Nigeria. These findings indicate a need to incorporate hysterolaparoscopy in the routine evaluation of female infertility in Nigeria.